| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Breast Imaging |
1 Departments of Radiology (R.J.J., S.I.F., M.J.S.)
2 Pathology (J.R.S.)
3 Surgery (F.A.M.), Palo Alto Medical Clinic, 300 Homer Ave, Palo Alto, CA 94301
4 Department of Pathology, Stanford University Medical Center, Stanford, Calif (K.W.N.).
PURPOSE: To determine the rate and causes of false-negative findings and histologic underestimates at stereotactic biopsy of nonpalpable breast lesions.
MATERIALS AND METHODS: Stereotactic, 14-gauge, automated, large-core needle biopsy (LCNB) was performed in 483 consecutive nonpalpable breast lesions. Excision was advised for the 143 carcinomas, 25 atypical ductal hyperplasia (ADH) lesions, and five radial scars. Mammographic follow-up was advised for the benign lesions without a repeat biopsy.
RESULTS: Of the 310 benign lesions, 259 underwent mammographic follow-up at 6–85 months (median, 55 months) without repeat biopsy, 48 underwent repeat biopsy and three were lost to follow-up. On the basis of the histologic diagnosis of carcinoma at surgical biopsy, diagnosis with LCNB was not correct (ie, disease was underestimated at histologic examination) in 14 (58%) of 24 ADH lesions and two (40%) of five radial scars. Two (1.2%) of 161 lesions with a final diagnosis of carcinoma were benign at LCNB but malignant at repeat biopsy (ie, false-negative findings at LCNB). Repeat biopsy was prompted by mammographic progression at 6 and 18 months after LCNB.
CONCLUSION: The false-negative rate with LCNB was 1.2% in this study and 4.0% in the literature. The presence of carcinoma in ADH and radial scar lesions was often underestimated.
Index terms: Biopsies, technology, 00.126 • Breast, biopsy, 00.126 • Breast, diseases, 00.31, 00.32 • Breast, ducts, 00.3119 • Breast, radial scar, 00.3119 • Breast neoplasms, diagnosis, 00.126
This article has been cited by other articles:
|
|
 |
|
  P. R. Eby, J. E. Ochsner, W. B. DeMartini, K. H. Allison, S. Peacock, and C. D. Lehman Frequency and Upgrade Rates of Atypical Ductal Hyperplasia Diagnosed at Stereotactic Vacuum-Assisted Breast Biopsy: 9-Versus 11-Gauge Am. J. Roentgenol., January 1, 2009; 192(1): 229 - 234. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. R. Eby, J. E. Ochsner, W. B. DeMartini, K. H. Allison, S. Peacock, and C. D. Lehman Is Surgical Excision Necessary for Focal Atypical Ductal Hyperplasia Found at Stereotactic Vacuum-Assisted Breast Biopsy? Ann. Surg. Oncol., November 1, 2008; 15(11): 3232 - 3238. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. R. Porembka, R. L. Abraham, J. A. Sefko, A. D. Deshpande, D. B. Jeffe, and J. A. Margenthaler Factors Associated with Lymph Node Assessment in Ductal Carcinoma in situ: Analysis of 1988-2002 Seer Data Ann. Surg. Oncol., October 1, 2008; 15(10): 2709 - 2719. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. F. Brem, M. C. Lechner, R. J. Jackman, J. A. Rapelyea, W. P. Evans, L. E. Philpotts, J. Hargreaves, and S. Wasden Lobular Neoplasia at Percutaneous Breast Biopsy: Variables Associated with Carcinoma at Surgical Excision Am. J. Roentgenol., March 1, 2008; 190(3): 637 - 641. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Pandey, M. J. Kornstein, W. Shank, and E. S. de Paredes Columnar Cell Lesions of the Breast: Mammographic Findings with Histopathologic Correlation RadioGraphics, October 1, 2007; 27(suppl_1): S79 - S89. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. C. Smitt and K. Horst Association of Clinical and Pathologic Variables with Lumpectomy Surgical Margin Status after Preoperative Diagnosis or Excisional Biopsy of Invasive Breast Cancer Ann. Surg. Oncol., March 1, 2007; 14(3): 1040 - 1044. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. H. Youk, E.-K. Kim, M. J. Kim, J. Y. Lee, and K. K. Oh Missed Breast Cancers at US-guided Core Needle Biopsy: How to Reduce Them RadioGraphics, January 1, 2007; 27(1): 79 - 94. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. K. Sydnor, J. D. Wilson, T. A. Hijaz, H. D. Massey, and E. S. Shaw de Paredes Underestimation of the Presence of Breast Carcinoma in Papillary Lesions Initially Diagnosed at Core-Needle Biopsy Radiology, December 1, 2006; 242(1): 58 - 62. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M F Dillon, C M Quinn, E W McDermott, A O'Doherty, N O'Higgins, and A D K Hill Diagnostic accuracy of core biopsy for ductal carcinoma in situ and its implications for surgical practice. J. Clin. Pathol., July 1, 2006; 59(7): 740 - 743. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Jackman and J. Rodriguez-Soto Breast microcalcifications: retrieval failure at prone stereotactic core and vacuum breast biopsy--frequency, causes, and outcome. Radiology, April 1, 2006; 239(1): 61 - 70. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. K. You, E.-K. Kim, J. Y. Kwak, M. J. Kim, K. K. Oh, B.-W. Park, and W. I. Yang Focal Fibrosis of the Breast Diagnosed by a Sonographically Guided Core Biopsy of Nonpalpable Lesions: Imaging Findings and Clinical Relevance J. Ultrasound Med., October 1, 2005; 24(10): 1377 - 1384. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. K. Koskela, M. Sudah, M. H. Berg, V. J. Karja, P. K. Mustonen, V. Kataja, and R. S. Vanninen Add-on Device for Stereotactic Core-Needle Breast Biopsy: How Many Biopsy Specimens Are Needed for a Reliable Diagnosis? Radiology, September 1, 2005; 236(3): 801 - 809. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. M. Lomoschitz, T. H. Helbich, M. Rudas, G. Pfarl, K. F. Linnau, A. Stadler, and R. J. Jackman Stereotactic 11-gauge Vacuum-assisted Breast Biopsy: Influence of Number of Specimens on Diagnostic Accuracy Radiology, September 1, 2004; 232(3): 897 - 903. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
X. Chen, C. D. Lehman, and K. E. Dee MRI-Guided Breast Biopsy: Clinical Experience with 14-Gauge Stainless Steel Core Biopsy Needle Am. J. Roentgenol., April 1, 2004; 182(4): 1075 - 1080. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. S. Burnside, D. L. Rubin, R. D. Shachter, R. E. Sohlich, and E. A. Sickles A Probabilistic Expert System That Provides Automated Mammographic-Histologic Correlation: Initial Experience Am. J. Roentgenol., February 1, 2004; 182(2): 481 - 488. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M Kennedy, A V Masterson, M Kerin, and F Flanagan Pathology and clinical relevance of radial scars: a review J. Clin. Pathol., October 1, 2003; 56(10): 721 - 724. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. B. Gordon, F. A. Gagnon, and L. Lanzkowsky Solid Breast Masses Diagnosed as Fibroadenoma at Fine-Needle Aspiration Biopsy: Acceptable Rates of Growth at Long-term Follow-up Radiology, October 1, 2003; 229(1): 233 - 238. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Kerlikowske, R. Smith-Bindman, B.-M. Ljung, and D. Grady Evaluation of Abnormal Mammography Results and Palpable Breast Abnormalities Ann Intern Med, August 19, 2003; 139(4): 274 - 284. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Jackman and F. A. Marzoni Jr. Stereotactic Histologic Biopsy with Patients Prone: Technical Feasibility in 98% of Mammographically Detected Lesions Am. J. Roentgenol., March 1, 2003; 180(3): 785 - 794. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Pandelidis, D. Heilman, D. Jones, K. Stough, J. Trapeni, and Y. Suliman Accuracy of 11-Gauge Vacuum-Assisted Core Biopsy of Mammographic Breast Lesions Ann. Surg. Oncol., January 1, 2003; 10(1): 43 - 47. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Brenner, R. J. Jackman, S. H. Parker, W. P. Evans III, L. Philpotts, B. M. Deutch, M. C. Lechner, D. Lehrer, P. Sylvan, R. Hunt, et al. Percutaneous Core Needle Biopsy of Radial Scars of the Breast: When Is Excision Necessary? Am. J. Roentgenol., November 1, 2002; 179(5): 1179 - 1184. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. L. Rosen, R. C. Bentley, J. A. Baker, and M. S. Soo Imaging-Guided Core Needle Biopsy of Papillary Lesions of the Breast Am. J. Roentgenol., November 1, 2002; 179(5): 1185 - 1192. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Jackman, R. L. Birdwell, and D. M. Ikeda Atypical Ductal Hyperplasia: Can Some Lesions Be Defined as Probably Benign after Stereotactic 11-gauge Vacuum-assisted Biopsy, Eliminating the Recommendation for Surgical Excision? Radiology, August 1, 2002; 224(2): 548 - 554. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Wunderbaldinger, G. Wolf, K. Turetschek, and T. H. Helbich Comparison of Sitting Versus Prone Position for Stereotactic Large-Core Breast Biopsy in Surgically Proven Lesions Am. J. Roentgenol., May 1, 2002; 178(5): 1221 - 1225. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Georgian-Smith, C. D'Orsi, E. Morris, C. F. Clark Jr., E. Liberty, and C. D. Lehman Stereotactic Biopsy of the Breast Using an Upright Unit, a Vacuum-Suction Needle, and a Lateral Arm-Support System Am. J. Roentgenol., April 1, 2002; 178(4): 1017 - 1024. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Shaffer, I. Khalkhali, and S. B. Haber Sestamibi Scanning of Breast Cancer J. Nucl. Med., January 1, 2002; 43(1): 125 - 126. [Full Text] [PDF]
|
|
|
|
 |
|
 H M Verkooijen, P H M Peeters, I H M Borel Rinkes, R M Pijnappel, A Kaya, W P T. M Mali, and T J M V van Vroonhoven Risk factors for cancellation of stereotactic large core needle biopsy on a prone biopsy table Br. J. Radiol., November 1, 2001; 74(887): 1007 - 1012. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. R. Margolin, J. W. T. Leung, R. P. Jacobs, and S. R. Denny Percutaneous Imaging-Guided Core Breast Biopsy: 5 Years' Experience in a Community Hospital Am. J. Roentgenol., September 1, 2001; 177(3): 559 - 564. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Sklair-Levy, T. H. Samuels, C. Catzavelos, P. Hamilton, and R. Shumak Stromal Fibrosis of the Breast Am. J. Roentgenol., September 1, 2001; 177(3): 573 - 577. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. K. Kuhl, N. Morakkabati, C. C. Leutner, A. Schmiedel, E. Wardelmann, and H. H. Schild MR Imaging-guided Large-Core (14-Gauge) Needle Biopsy of Small Lesions Visible at Breast MR Imaging Alone Radiology, July 1, 2001; 220(1): 31 - 39. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Liberman, C. L. Benton, D. D. Dershaw, A. F. Abramson, L. R. LaTrenta, and E. A. Morris Learning Curve for Stereotactic Breast Biopsy: How Many Cases Are Enough? Am. J. Roentgenol., March 1, 2001; 176(3): 721 - 727. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Brenner, L. W. Bassett, L. L. Fajardo, D. D. Dershaw, W. P. Evans III, R. Hunt, C. Lee, I. Tocino, P. Fisher, M. McCombs, et al. Stereotactic Core-Needle Breast Biopsy: A Multi-institutional Prospective Trial Radiology, March 1, 2001; 218(3): 866 - 872. [Abstract] [Full Text]
|
|
|
|
|
|
R. J. Jackman, F. Burbank, S. H. Parker, W. P. Evans III, M. C. Lechner, T. R. Richardson, A. A. Smid, H. B. Borofsky, C. H. Lee, H. M. Goldstein, et al. Stereotactic Breast Biopsy of Nonpalpable Lesions: Determinants of Ductal Carcinoma in Situ Underestimation Rates Radiology, February 1, 2001; 218(2): 497 - 502. [Abstract] [Full Text]
|
|
|
|
|
|
M. L. R. Darling, D. N. Smith, S. C. Lester, C. Kaelin, D.-L. G. Selland, C. M. Denison, P. J. DiPiro, D. I. Rose, E. Rhei, and J. E. Meyer Atypical Ductal Hyperplasia and Ductal Carcinoma In Situ as Revealed by Large-Core Needle Breast Biopsy: Results of Surgical Excision Am. J. Roentgenol., November 1, 2000; 175(5): 1341 - 1346. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. E. Philpotts, C. H. Lee, L. J. Horvath, R. C. Lange, D. Carter, and I. Tocino Underestimation of Breast Cancer with II-Gauge Vacuum Suction Biopsy Am. J. Roentgenol., October 1, 2000; 175(4): 1047 - 1050. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Liberman, L. A. Ernberg, A. Heerdt, M. F. Zakowski, E. A. Morris, L. R. LaTrenta, A. F. Abramson, and D. D. Dershaw Palpable Breast Masses: Is There a Role for Percutaneous Imaging-Guided Core Biopsy? Am. J. Roentgenol., September 1, 2000; 175(3): 779 - 787. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. E. Philpotts, N. A. Shaheen, K. S. Jain, D. Carter, and C. H. Lee Uncommon High-Risk Lesions of the Breast Diagnosed at Stereotactic Core-Needle Biopsy: Clinical Importance Radiology, September 1, 2000; 216(3): 831 - 837. [Abstract] [Full Text]
|
|
|
|
|
|
M. Guenin, C. H. Lee, L. E. Philpotts, L. J. Horvath, and I. Tocino The Low False-Negative Rate for Stereotactic Breast Biopsy Dr Lee and colleagues respond: Radiology, August 1, 2000; 216(2): 609 - 610. [Full Text]
|
|
|
|
|
|
L. Liberman and M. P. Sama Cost-Effectiveness of Stereotactic 11-Gauge Directional Vacuum-Assisted Breast Biopsy Am. J. Roentgenol., July 1, 2000; 175(1): 53 - 58. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Liberman Percutaneous Imaging-Guided Core Breast Biopsy: State of the Art at the Millennium Am. J. Roentgenol., May 1, 2000; 174(5): 1191 - 1199. [Full Text] [PDF]
|
|
|
|
|
|
J. S. Greenberg and D. H. Smetherman Invited Commentary RadioGraphics, October 1, 1999; 19(90001): 36 - 37. [Full Text]
|
|
|
|
|
|
C. H. Lee, L. E. Philpotts, L. J. Horvath, and I. Tocino Follow-up of Breast Lesions Diagnosed as Benign with Stereotactic Core-Needle Biopsy: Frequency of Mammographic Change and False-Negative Rate Radiology, July 1, 1999; 212(1): 189 - 194. [Abstract] [Full Text]
|
|
|
|
|
|
R. J. Jackman and R. L. Lamm Stereotactic Histologic Biopsy in Breasts with Implants Radiology, January 1, 2002; 222(1): 157 - 164. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| RADIOLOGY | RADIOGRAPHICS | RSNA JOURNALS ONLINE |
